Reflections on an Epidemic

I was shocked by something this past Fall. At our conference in Charlottesville, RJ Heijmen showed a clip of a father telling the story of his son’s suicide and the emotional and spiritual agony it caused. The man’s words could not have possibly been heavier, and I almost questioned whether we had crossed a line. But that wasn’t what shocked me. What shocked me was the number of people who approached me afterward to share a similar story. Nearly a quarter of those in attendance had experienced the suicide of a close friend or family member. Granted, we are only talking about 150 people or so–and I’m well aware that the group who signs up for an event about “hope in the ruins” is pretty self-selecting–but still, it threw me.

Suicide is not something we talk about very often in any context, church or otherwise, for obvious reasons. So to discover how many in that room had been directly affected by it felt like a sheet being pulled back to reveal what Tim Kreider calls one of “the secret histories of the world.”

The timing of the announcement was terrible (though it’s not as though the timing for this sort of thing could have ever been good), overshadowed as it was by the real-time tragedies in Boston and Oklahoma. Even so, one can’t help but feel that the report–and its implications–were glossed over. As painful and awful as those other events may be, they are at least concrete. A soaring suicide rate, on the other hand, especially among a certain demographic (see below), may be too intangible and uncomfortable and close to the bone to absorb. Still, denying the deep sadness and despair that marks so many lives is the opposite of loving–indeed, it exacerbates the loneliness for everyone involved. Same with dismissing the issue as purely circumstantial or political (both left and right wasted little time in attributing the rise to faults in one another’s policies).

The only publication I’ve seen pick the subject up with much gusto is Newsweek, which featured Tony Dokoupil’s expert treatment on its cover a couple of weeks ago. If “The Suicide Epidemic” sounds like an alarmist title for the article, well, the numbers are fairly alarming–no matter how you slice them. Thankfully, Dokoupil does more than break them down for us, he profiles Thomas Joiner, a professor at Florida State and one of the world’s only leading authorities on the subject. Together they paint a grim picture, and not just about self-harm, but suffering and loneliness in general, escalating mental illness, and ultimately, humankind as its own worst enemy in the most nauseatingly literal sense. More commentary throughout:

We know, thanks to a growing body of research on suicide and the conditions that accompany it, that more and more of us are living through a time of seamless black: a period of mounting clinical depression, blossoming thoughts of oblivion and an abiding wish to get there by the nonscenic route. Every year since 1999, more Americans have killed themselves than the year before, making suicide the nation’s greatest untamed cause of death. In much of the world, it’s among the only major threats to get significantly worse in this century than in the last.

The result is an accelerating paradox. Over the last five decades, millions of lives have been remade for the better. Yet within this brighter tomorrow, we suffer unprecedented despair. In a time defined by ever more social progress and astounding innovations, we have never been more burdened by sadness or more consumed by self-harm. And this may be only the beginning. If Joiner and others are right—and a landmark collection of studies suggests they are—we’ve reached the end of one order of human history and are at the beginning of a new order entirely, one beset by a whole lot of self-inflicted bloodshed, and a whole lot more to come…

This year, America is likely to reach a grim milestone: the 40,000th death by suicide, the highest annual total on record, and one reached years ahead of what would be expected by population growth alone… This development evades simple explanation. The shift in suicides began long before the recession, for example, and although the changes accelerated after 2007, when the unemployment rate began to rise, no more than a quarter of those new suicides have been tied to joblessness, according to researchers. Guns aren’t all to blame either, since the suicide rate has grown even as the portion of suicides by firearm has remained stable.

Throughout the developed world, for example, self-harm is now the leading cause of death for people 15 to 49, surpassing all cancers and heart disease. That’s a dizzying change, a milestone that shows just how effective we are at fighting disease, and just how haunted we remain at the same time. Around the world, in 2010 self-harm took more lives than war, murder, and natural disasters combined, stealing more than 36 million years of healthy life across all ages…

The suicide rate for Americans 45 to 64 has jumped more than 30 percent in the last decade, according to the new CDC report, and it’s possible to slice the data even more finely than they did. Among white, middle-aged men, the rate has jumped by more than 50 percent, according to a Newsweek analysis of the public data. If these guys were to create a breakaway territory, it would have the highest suicide rate in the world. In wealthy countries, suicide is the leading cause of death for men in their 40s, a top-five killer of men in their 50s, and the burden of suicide has increased by double digits in both groups since 1990. The situation is even more dramatic for white, middle-aged women, who experienced a 60 percent rise in suicide in that same period, a shift accompanied by a comparable increase in emergency-room visits for drug-related (usually prescription-drug-related) attempts to die…

When teen suicide was on the rise in the 1970s and 1980s, society was stung by the conclusion that something must be wrong with the way we live, because our children don’t want to join us. The question today is different, but just as unsettling. With people relinquishing life at its supposed peak, what does that say about the prize itself? What’s gone so rotten in the modern world?

I know what you’re thinking: perhaps he is overstating things a little–the world is no more or less rotten today than it has ever been. While that’s certainly true as far as the human condition itself is concerned, there’s a big difference between being stuck in webs of our own making (in the same way we always have been) and being filled with such despair that we want to end things. After all, we are usually pretty enraptured by whatever’s keeping us captive.

So what is it about current iterations of human dysfunction, especially in educated circles–e.g. narcissism, materialism, careerism, techno-solutionism, internet-never-forgets-ism, hyper-litigiousness, etc–that have pushed so many over the brink? I’m not entirely sure. And I’m not entirely sure that understanding the precise reasons for it is all that important, as knowledge only goes so far when it comes to addressing real mental anguish. But I can recognize an opening for an honest discussion about the nature of sin and redemption, law and grace, death and resurrection, when I see one.

Indeed, the church has more to contribute here than just community (though embodied grace does go a long way). We can talk about hope that is rooted outside of us and our instincts, beyond prizes and striving and all that–hope that acknowledges the depth of human suffering, self-inflicted and otherwise, yet doesn’t end there. Then again, it feels pretty callous to use these numbers to prove some theological point. Perhaps it is enough simply to ruminate on the clear-as-day reality that what we think brings us happiness and what actually brings us happiness are two very separate things. And that’s not some pat religious notion. The stakes are extremely high. Especially at this time of year:

Spring is the start of suicide season, the time when the average daily death toll begins its climb to a mid-summer peak, before tapering through fall and winter. This is one of the strongest findings in the field, a 200-year debunking of Herman Melville’s damp, drizzly November of the soul. One respected 19th-century French researcher actually calculated a boiling point for suicidal desire. It’s 82 degrees, basically paradise…

[One can’t help but think of the absurd number of apocalyptic and post-apocalyptic visions at the box office this summer. Pop culture may be a relatively innocuous gauge, but clearly our collective imagination–American and otherwise–has taken a dark and dire turn of late.]

If four out of five suicide attempts are by women, why are four out of five suicides by men? If big cities and beautiful architecture are magnets for suicide, why are natural wonders and public parks as well? Prostitutes, athletes, and bulimics have an above-average risk for suicide, but what else do they have in common? Why are African-American people relatively safe? And twins?…

The life-saving power of belonging may help explain why, in America, blacks and Hispanics have long had much lower suicide rates than white people. They are more likely to be lashed together by poverty, and more enduringly tied by the bonds of faith and family. In the last decade, as suicide rates have surged among middle-aged whites, the risk for blacks and Hispanics of the same age has increased less than a point—although they suffer worse health by almost every other measure…

When people see themselves as effective—as providers for their families, resources for their friends, contributors to the world—they maintain the will to live. When they lose that view of themselves, when it curdles into a feeling of liability, the desire to die takes root. We need each other, but if we feel we are failing those we need, the choice is clear. We’d rather be dead. This explains why suicides rise with unemployment, and also with the number of days a person has been on bed rest. Just the experience of needing and receiving help from friends—rather than doing for oneself and others—can make a person pine for death. We’re a gregarious species, but also a gallant one, so fond of playing the savior that we’d rather die than switch roles with the saved. In this way suicide isn’t the ultimate act of selfishness or a bid for revenge, two of the more common cultural barbs. It’s closer to mistaken heroism…

Woah. I’m not sure I could handle a more visceral distillation of Original Sin. As Moltmann made so clear in yesterday’s excerpt from The Crucified God, the human creature is not neutral when it comes to what saves us–we actively flee it. We fight humility, often to the death. And yet. And yet… the place of deconstruction so often marks the beginning of hope, does it not? To paraphrase Paul Westerberg, the “first glimmer of light” shines in the darkness, thank God. On that note, here’s Paul singing about how Sylvia Plath ended her own life:

Somehow Dokoupil keeps going with some observations about how law compounds despair:

The recession can’t explain the new trends in suicide, but longer-term structural changes in the economy may undergird many of them. Only recently have economists begun to focus on the psychological impact of income inequality, tying the wealth and happiness of all to the risk of suicide for some. If you make 10 percent less than your neighbor, for example, you are 4.5 percent more likely to die by suicide, according to a paper led by Mary C. Daly, who works for the Federal Reserve Bank in San Francisco. In an earlier study, she and colleagues found that suicide rates generally rise with measures of national “happiness,” a fact that accords nicely with Joiner’s ideas about alienation and burdensomeness. It’s hard to be sad and alone, and even harder if others seem too happy to disturb.

A couple of closing observations: The faith aspect mentioned above–i.e. the research showing that church attendance correlates to lower risk of suicide–is encouraging, though not without qualification. Lest Christians start pitching church as being “good for your (mental) health” and confuse means with ends once again, that is. Church can be beneficial, of course, but it completely depends on the church, and as much as I hate to say it, churches that explicitly appeal to our desire for results/improvement tend not to be the kind that are ultimately all that helpful. As that final stat attests, if church becomes yet another venue for comparison, it negates any benefit it might have provided by virtue of the relationships one forms there.

We talk so much on here about the dangers of law and judgment in a grace-less vacuum not because it is somehow “bad” or like little children/teenagers we don’t like it, but because these things isolate a suffering person, causing them to hide and pushing them away when they most need to be brought closer. The same is true for all the endless material about the ugly side of the human condition. If we’re not dealing with the truth, we’re not dealing with God. To me, Dokoupil’s article is a timely reminder that these notions are not some theological hobby horse but represent, at the risk of sounding dramatic, the difference between death and life.

By way of illustration, I remember walking out of church one Sunday in the not-so-distant past and hearing someone complain about a sermon being too morbid and individualistic, where was the joy of the redeemed life, etc. They had a point–Lord knows insecurity can prompt a person to adopt “an edge” simply to attract attention or justify ourselves/our anger. The flipside here is that if there was a suicidal person in that audience, they might have felt addressed for once. One never knows when someone like that is going to occupy a pew. But it looks like I’ve stumbled into the realm of ecclesiology, of churches functioning as hospitals rather than schoolhouses, which is not exactly this writer’s comfort zone.

The larger lesson, if it can be called such, is simply that people are suffering. I mean, really suffering–and not “out there” but right here, right now. Regardless of our context, regardless of how things may appear, we are a threat to ourselves and in need of salvation from ourselves, and not just cosmically or theologically speaking. This sounds like an obvious point, but however self-evident it may be (both biblically and experientially), we always seem to resist it. It may be scant comfort in the midst of a suicidal situation, but that does not change the fact that it is exactly to such people that the Gospel of grace speaks most loudly.

Sometimes, on this side of paradise, preaching the Gospel can seem like something of a “head-trip.” One can often wonder whether there is real value in attempting to assuage people’s emotional, psychological and spiritual pains, as opposed to meeting their more “physical” needs (I recognize that this is something of a false dichotomy, but it speaks to the validity of ministry to the “rich”). This article puts that doubt to bed, at least for me, powerfully demonstrating that what is seen matters so much less than what is not. Thanks DZ.

It does not surprise me at all that people commit suicide when the weather is good, when they are successful, etc. One who is depressed can still hope that things will be better if/when something happens (fill in the blank — get married, get promoted, have kids, whatever). Then the if/when happens, and happiness does not actually come. If one does not know the true source of hope, then the depressed person is left with despair.

My mother committed suicide when I was 8 years old. I used to regularly struggle with wanting to die — when she died, and at many other times before I was a Christian. My greatest successes (I had everything!) led to an existential crisis (nothing in myself or in this world will make me happy) that fortunately led me to Jesus.

Then, as a Christian suffering from severe post-partum depression, I would have killed myself if I had not known It was not God’s will for me and, most importantly, other Christians supporting my family and me in many ways. (Then God delivered me from the depression, but that’s another story.)

This is an outstanding post. Thank you for the courage and risk. I appreciate the insight about some in church complaining about a sermon being too morbid and introspective. How revealing. Here in Seattle, a HS graduation speaker was booed off the stage for giving a dark and morbid address. I read the speech, and found the honesty of the content compelling and provocative. We do need saving from ourselves. The gospel is our only hope. But we must be willing to face the truth about ourselves and the world. We run from that.

Thanks for writing on this. The whole situation is perhaps even more dire than you have described. The number of people that we know that unsuccessfully attempt suicide is easily 10 times more than those that actually succeed in taking their lives. I have been a paramedic for 18 years and have treated hundreds of unsuccessful attempts in my career.

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